Experience with the Nidek MK-2000 microkeratome in 1,220 cases.

PURPOSE: To evaluate the performance of the Nidek MK-2000 microkeratome.

METHODS

The Nidek MK-2000 microkeratome was used in 1,220 cases of LASIK with the Nidek EC-5000 excimer laser. Patients had a wide range of myopia (-0.75 to -25.00 D), hyperopia (+0.75 to +9.00 D) and/or astigmatism (-7.00 to +6.50 D). The flap was created with the 130-microm microkeratome plate for 859 eyes, and the 160-microm plate for 361 eyes. In 632 eyes, the 8.5-mm ring was used, and the 9.5-mm ring was used in 588 eyes. The flap hinge was placed nasally, superiorly, or inferiorly depending on the needs of the case. An easy external modification allowed us to gently increase and decrease the vacuum level and to perform the procedure using a low vacuum regimen, if necessary.

RESULTS

The edges of the flaps and the corneal surface were of good quality in all eyes. No free flaps were noted. One case was aborted because of inappropriate flap formation in a patient with a large difference (6.50 D) in corneal curvature in two main meridians. This patient successfully underwent LASIK 1 month later, placing the flap hinge in the opposite direction. Small epithelial shrinkage was noted in 38 eyes. No other flap complications were noted. In all patients the flap diameter and thickness were close to that estimated by the manufacturer. The vacuum level was adequate and stable in all cases.

CONCLUSION

The Nidek MK-2000 microkeratome was easy to use, predictable, and safe. However, we suggest a modification, adding an adjustable head movement to create wider hinge-to-center-of-pupil distance and an additional 9.0-mm suction ring.